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Individual

APAMA K CHILDERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.A.

Contact information

Practice address
900 N HERITAGE DR STE E, RIDGECREST, CA 93555-5537
(760) 446-8281
(760) 446-0970
Mailing address
900 N HERITAGE DR STE E, RIDGECREST, CA 93555-5537
(760) 446-4571
(760) 446-0970

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA10602
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00G570660
COMMERCIAL
05
00G570660
CA
01
010032908
RAILROAD MEDICARE
01
0616650001
DME
01
0PA106020
BLUE SHIELD
01
154460165
PALMETTO
01
688278
AHI HEALTHLINK
01
93555B033
WPS TRICARE
01
CA0103
JOHN DEERE
01
G57066
IMG
Enumeration date
06/13/2005
Last updated
09/02/2014
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